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Although persons with severe disabilities comprise about 15 percent of individuals receiving Medicaid services in Washington, they account for about 27 percent of all Medicaid expenditures. A major component of these expenditures is for outpatient services, such as prescription drugs and physician office visits. In this report, we focus on three key factors: i) change in price; ii) change in utilization; and iii) change in caseload size, to explain why expenditures on outpatient services provided to Medicaid recipients with severe disabilities have increased between 1999 and 2001.